Clin Nutr Res.  2019 Jul;8(3):171-183. 10.7762/cnr.2019.8.3.171.

Importance of Adherence to Personalized Diet Intervention in Obesity Related Metabolic Improvement in Overweight and Obese Korean Adults

• An J
• Yoon SR
• Lee JH
• Kim H
• Kim OY

• KMID: 2454075
• DOI: http://doi.org/10.7762/cnr.2019.8.3.171

Abstract

We investigated weight loss effect of personalized diet education in overweight/obese Korean adults. Overweight/obese Korean adults (body mass index [BMI] ≥ 23 kg/m2 or waist circumference [WC] ≥ 90 cm for men, ≥ 85 cm for women) were recruited, and 40 participants who completed the 10-week intervention were finally included in the analyses. At first visit, study participants (small group with individual counseling) were educated for optimal diet by clinical dietitian, and checked for their compliance through telephone/text message every 1-2 week during the intervention. Anthropometric and biochemical parameters and dietary intake were investigated. Body weight, BMI, WC, and body fat mass were significantly reduced in whole participants. Hemoglobin A1c, insulin, and low-density lipoprotein cholesterol were also significantly decreased after the intervention. Total energy intake (EI) during the intervention was not significantly decreased compared to the baseline value, but the proportions of energy derived from macronutrients were within the ranges recommended by 2015 Dietary Reference Intake for Koreans. Based on actual EI, participants were classified into high-adherence (HA) (prescribed EI ± 25%, n = 29), low-adherence I (LA-I) (< 75% of prescribed EI, n = 7), and low-adherence II (LA-II) group (> 125% of prescribed EI, n = 4). Only HA group showed significant improvements in anthropometric parameters, glycemic control and lipid profile. Interestingly, LA-I group showed significant increases in glucose, insulin, C-peptide and insulin resistance. In conclusion, a shift from overweight/obesity to healthy weight can be accomplished by high adherence to personalized diet modification, not by EI reduction.

Keyword

Obesity; Diet; Weight; Insulin resistance; Lipid

MeSH Terms

Adipose Tissue
Adult*
Body Weight
C-Peptide
Cholesterol
Compliance
Diet*
Education
Energy Intake
Food Habits
Glucose
Humans
Insulin
Insulin Resistance
Lipoproteins
Male
Nutritionists
Obesity*
Overweight*
Recommended Dietary Allowances
Waist Circumference
Weight Loss
C-Peptide
Cholesterol
Glucose
Insulin
Lipoproteins

Figure

• 

  Figure 1 Changes in anthropometric parameters after nutrition education intervention. Data presented as means ± SE. BMI, body mass index; WC, waist circumference; VFA, visceral fat area; BFM, body fat mass; HA, high adherence group; LA-I, low adherence I group; LA-II, low adherence II group; SE, standard error. *Significant difference compared to baseline within group (p < 0.05), †significant difference compared to baseline (p < 0.01).

• 

  Figure 2 Changes in glycemic status after nutrition education intervention. Data presented as means ± SE. HbA1c, hemoglobin A1c; HOMA-IR, homeostasis model assessment of insulin resistance; HA, high adherence group; LA-I, low adherence I group; LA-II, low adherence II group; SE, standard error. *No significant difference, but trend, p < 0.1; †significant difference compared to baseline within group (p < 0.05), ‡significant difference compared to baseline (p < 0.01); §tested after log transformed due to the skewed distribution.

• 

  Figure 3 Changes in lipid profile, liver and kidney functions after nutrition education intervention. Data presented as means ± SE. LDL-C, low-density lipoprotein cholesterol; AST, aspartate aminotransferase; ALT, alanine aminotransferase; HA, high adherence group; LA-I, low adherence I group; LA-II, low adherence II group; SE, standard error. *Significant difference compared to baseline within group (p < 0.05).

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